ESMO Asia Congress 2022

Abstract 107P

Background

Hepatocellular carcinoma (HCC), which comprises the majority of liver cancer was a leading cause of death worldwide. The high rate of recurrence severely hampers the long-term survival of HCC patients after hepatectomy. Early recurrence, which is mainly caused by intrahepatic dissemination, accounts for nearly 70% of all recurrent cases. Circulating tumor cells (CTC) has shown potential clinical implications. CTC was associated with the severity of microvascular invasion (mVI) in the peritumoral tissue. Patients with positive CTC have higher risk of recurrence, associate with poorer survival. However, it remains unclear whether CTC is helpful in guiding the surgical plan.

Methods

In this perspective design, retrospective study, we enrolled 60 eligible patients with resectable HCC, and Child-Pugh A liver function, preoperative CTC detection was positive between January 2021 and May 2022. Thirty patients underwent anatomical resection (AR) and 30 patients underwent non-anatomical resection (NAR), clinical outcomes including clinicopathologic characteristics, recurrence-free survival (RFS) were compared.

Results

There was no significant difference in the preoperative data and incidence of blood loss and transfusion requirements between the AR group and the NAR group, although wedge resection was mainly performed in the NAR group. No major complications occurred in either group. All patients achieved radical resection, and 25 patients (41.7%, 25/60) were mVI-positive in the pathological detection. There were17 mVI-positive in the AR group and 8 mVI-positive in the NAR group. During follow-up, recurrence was more frequent in patients treated with NAR, there was 8 (26.6%) recurrence in the NAR group and 3 (10%) recurrence in the AR group. The 1-year RFS in AR and NAR groups were 90% and 73.3% (p＜0.05). Multivariate analysis showed the type of surgical treatment was an independent predictor of disease recurrence.

Conclusions

In conclusion, preoperative CTC status correlated with and predicted mVI in HCC patients. AR should be performed in CTC positive in preoperative patients for ensuring disease eradication. Based on the preliminary results, randomized controlled trials will be conducted.